Vinorelbine and cisplatin
chemotherapy

Vinorelbine and cisplatin (VP) is a combination treatment used to treat non-small cell lung cancer.

It is best to read this information with our general information about chemotherapy and the type of cancer you have.

Vinorelbine can be given into a vein or as capsules. Cisplatin is given into a vein. You usu-ally have this treatment as an outpatient or during a hospital stay. Your cancer doctor or nurse will tell you how often you will have it.

Vinorelbine and cisplatin can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.

Your healthcare team can give you advice on how to manage any side effects. Tell your doc-tor or nurse straight away if you:

have a temperature

feel unwell

have severe side effects, including any we do not mention here.

Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

Chemotherapy

How vinorelbine and cisplatin is given

You will be given vinorelbine and cisplatin (VP) in the chemotherapy day unit or during a short stay in hospital. A chemotherapy nurse will give it to you.

During treatment you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.

Before or on the day of treatment, a nurse or a person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy.

You will see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.

Your nurse usually gives you anti-sickness (anti-emetic) drugs before the chemotherapy. The chemotherapy drugs can be given through:

a short thin tube put into a vein in your arm or hand (cannula)

a fine tube that goes under the skin of your chest and into a nearby vein (central line)

a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line).

Your nurse will give you vinorelbine as a drip (infusion) over about 5 to 10 minutes. After this, they will give you cisplatin as a drip for about two hours. They usually give the drip through a pump, which gives you the treatment over a set time. You will have extra fluids through your drip before and after the cisplatin. This is to protect your kidneys.

Your course of chemotherapy

You usually have a course of several cycles of treatment over a few months. Your nurse or doctor will discuss your treatment plan with you. Each cycle of VP chemotherapy usually takes 21 days (3 weeks).

On day 1, you have vinorelbine and cisplatin. On day 7, you will have blood samples taken. If your blood results are okay, on day 8 you have another dose of vinorelbine. You will then have a rest period with no chemotherapy from days 9 to 21. This completes one cycle of chemotherapy.

At the end of the 21 days, you start your second cycle of treatment. This will be the same as the first cycle.

Your nurse or doctor will discuss your treatment plan with you.

Taking your chemotherapy capsules

The nurse or pharmacist may give you vinorelbine capsules to take at home. Always take your capsules exactly as explained. This is important to make sure they work as well as possible for you. You should swallow the capsules whole, with water and after a meal. They should not be chewed, opened or crushed.

If you are sick just after taking the capsules, contact the hospital. You should not take another dose.

If you forget to take the capsules, you should take the missed dose as soon as possible 24 hours. If it has been longer than 24 hours, let your doctor or nurse know.

Other things to remember about your capsules:

Keep them in the original package and store them in the fridge.

Keep them safe and out of the reach of children.

Return any remaining capsules to the pharmacist if your treatment is stopped.

Going home

Before you go home, the nurse or pharmacist will give you anti-sickness (anti-emetic) drugs to take. They may also give you anti-diarrhoea tablets if you need them. Take all your tablets exactly as they have explained to you.

Having your PICC line put in

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects. You may get some of the side effects we mention, but you are unlikely to get all of them.

You may also have some side effects that we haven’t listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for these drugs. The leaflet lists all known side effects.

Side effects during treatment

Some people may have side effects while they are being given the treatment or shortly after they have it:

Allergic reaction

Some people have an allergic reaction while having this treatment. Signs of a reaction can include:

feeling hot or flushed

a skin rash

itching

shivering

feeling dizzy

a headache

feeling breathless

swelling of your face or mouth

pain in your back, tummy or chest.

Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, it can be treated quickly.

Sometimes a reaction can happen a few hours after treatment. If you get any signs or feel unwell after you get home, contact the hospital straight away.

The drug leaks outside the vein

If this happens it can damage the tissue around the vein. This is called extravasation. Extravasation is not common but if it happens, it is important that it is dealt with quickly. Tell your nurse straight away if you have any stinging, pain, redness or swelling around the vein.

If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the number they gave you.

Pain along the vein

You may get pain at the place where the injection is given or along the vein. If you feel pain, tell your nurse or doctor straight away so that they can check the site. They may give the drug more slowly or flush it through with more fluid to reduce pain.

Common side effects

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

your temperature goes over 37.5°C (99.5F)

you suddenly feel unwell, even with a normal temperature

you have symptoms of an infection.

Symptoms of an infection include:

feeling shivery

a sore throat

a cough

diarrhoea

needing to pass urine often.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cell count is low, your doctor may delay your treatment for a short time.

Bruising and bleeding

Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor or nurse if you have any bruising or bleeding that you can’t explain. This includes:

Anaemia (low number of red blood cells)

Chemotherapy can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Feeling sick

You may feel sick in the first few days after chemotherapy. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluids and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.

Constipation

This treatment can cause constipation. Here are some tips that may help:

Drink at least two litres (three and a half pints) of fluids each day.

Eat high-fibre foods, such as fruit, vegetables and wholemeal bread.

Do regular gentle exercise, like going for short walks.

If you have constipation, contact the hospital for advice. Your doctor can give you drugs called laxatives to help.

Diarrhoea

If you have diarrhoea, contact the hospital for advice. Try to drink at least two litres (three and a half pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

Sore mouth

You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth is sore:

tell your nurse or doctor – they can give you a mouthwash or medicines to help

try to drink plenty of fluids

avoid alcohol, tobacco, and foods that irritate your mouth.

Effects on the kidneys

Cisplatin can affect how your kidneys work. You will have blood tests before and during treatment to check this.

Before and after each treatment, your nurses will give you extra fluids through a drip. This is to protect your kidneys. It’s also important to drink at least two litres (three and a half pints) of fluids each day.

If you pass less urine than usual, tell your nurse.

Numb or tingling hands or feet (peripheral neuropathy)

Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug or delay treatment for a short time. The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.

Muscle or joint pain

You may get pain in your muscles or joints for a few days after chemotherapy. If this happens, tell your doctor so they can give you painkillers. Tell them if the pain does not get better. Having warm baths and taking regular rests may help.

Hair loss

Your hair will get thinner or you may lose all the hair from your head. You may also lose your eyelashes, eyebrows or other body hair. Hair loss usually starts after your first or second treatment.

Your nurse can talk to you about ways to cope with hair loss. There are ways to cover up hair loss if you want to. It is important to cover your head to protect your scalp when you are out in the sun.

Hair loss is almost always temporary and your hair will usually grow back after treatment ends.

Changes to your taste

You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste bad or have no taste. Try different foods to find out what tastes best to you. Taste changes usually get better after treatment finishes. Your nurse can give you more advice.

Loss of appetite

This treatment can affect your appetite. Do not worry if you don’t eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.

Coping with fatigue

Less common side effects

Changes in hearing

Cisplatin can affect your hearing. You may have a hearing test before you start treatment. You may get ringing in your ears (tinnitus) and lose the ability to hear some high-pitched sounds. Tinnitus usually gets better after treatment ends. Some hearing changes can be permanent. Tell your doctor if you notice any changes in your hearing.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:

pain, redness or swelling in a leg or arm

breathlessness

chest pain.

If you have any of these symptoms, contact a doctor straight away.

A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.

Other medicines

Some medicines can affect chemotherapy or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.

Fertility

Some cancer drugs can affect whether you can get pregnant or father a child. If you are worried about this, it is important to talk with your doctor before you start treatment.

Contraception

Your doctor will advise you not to get pregnant or father a child while having this treatment. The drugs may harm the developing baby. It is important to use effective contraception.

Sex

If you have sex in the first few days after chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.

Breastfeeding

Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

Thanks

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